Provider Demographics
NPI:1124049242
Name:PAULA SJOLUND, DO, LLC
Entity type:Organization
Organization Name:PAULA SJOLUND, DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SJOLUND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-828-1175
Mailing Address - Street 1:72 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1220
Mailing Address - Country:US
Mailing Address - Phone:732-828-1175
Mailing Address - Fax:732-828-1195
Practice Address - Street 1:72 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1220
Practice Address - Country:US
Practice Address - Phone:732-828-1175
Practice Address - Fax:732-828-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB58170261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF90761Medicare UPIN
485598Medicare ID - Type Unspecified